Impact of the type of anthracycline and of stem cell transplantation in younger patients with acute myeloid leukaemia: Long‐term follow up of a phase III study
- 31 March 2020
- journal article
- research article
- Published by Wiley in American Journal of Hematology
- Vol. 95 (7), 749-758
- https://doi.org/10.1002/ajh.25795
Abstract
We provide a long‐term evaluation of patients enrolled in the EORTC/GIMEMA AML‐10 trial which included a total of 2157 patients, 15‐60 years old, randomized to receive either daunorubicin (DNR, 50 mg/m2), mitoxantrone (MXR, 12 mg/m2), or idarubicin (IDA, 10 mg/m2) in addition to standard‐dose cytarabine and etoposide for induction chemotherapy and intermediate dose cytarabine for consolidation. Younger patients who reached complete remission with complete (CR) or incomplete (CRi) recovery were then scheduled to receive an allogeneic hematopoietic stem cell transplantation (HSCT) if they had a HLA‐identical sibling donor; in all other cases, an autologous HSCT had to be administered. At an 11‐year median follow‐up, the 5‐, 10‐ and 15‐year overall survival (OS) rates were 33.2%, 30.1% and 28.0%, respectively. No significant difference between the 3 randomized groups regarding OS was observed (P=0.38). In young patients, 15‐45 years old, no treatment difference (P=0.89) regarding OS was observed, while in patients 46‐60 years old, MXR and IDA groups had a trend for a longer OS as compared to the DNR group (P=0.029). Among younger patients without a favourable MRC cytogenetic risk subgroup who achieved a CR/CRi after induction chemotherapy, those with a HLA‐identical sibling donor had higher 10‐ and 15‐ year OS rates than those without. In older patients who reached CR/CRi, the long‐term outcomes of those with or without a donor was similar. In conclusion, long‐term outcomes of the study confirmed similar OS in the 3 randomized groups in the whole cohort of patients.This publication has 27 references indexed in Scilit:
- Long-Term Survival and Late Deaths After Allogeneic Hematopoietic Cell TransplantationJournal of Clinical Oncology, 2011
- Refinement of cytogenetic classification in acute myeloid leukemia: determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trialsBlood, 2010
- Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNetBlood, 2010
- Daunorubicin Versus Mitoxantrone Versus Idarubicin As Induction and Consolidation Chemotherapy for Adults With Acute Myeloid Leukemia: The EORTC and GIMEMA Groups Study AML-10Journal of Clinical Oncology, 2009
- Anthracycline Dose Intensification in Acute Myeloid LeukemiaThe New England Journal of Medicine, 2009
- Hematopoietic cell transplantation after reduced-intensity conditioning for older adults with acute myeloid leukemia in complete remissionCurrent Opinion in Hematology, 2007
- Results of a HOVON/SAKK donor versus no-donor analysis of myeloablative HLA-identical sibling stem cell transplantation in first remission acute myeloid leukemia in young and middle-aged adults: benefits for whom?Blood, 2007
- Allogeneic compared with autologous stem cell transplantation in the treatment of patients younger than 46 years with acute myeloid leukemia (AML) in first complete remission (CR1): an intention-to-treat analysis of the EORTC/GIMEMAAML-10 trialBlood, 2003
- A Proportional Hazards Model for the Subdistribution of a Competing RiskJournal of the American Statistical Association, 1999
- Evaluation of Response-Time Data Involving Transient States: An Illustration Using Heart-Transplant DataJournal of the American Statistical Association, 1974